This is defined as inflammation of the patella at its insertion point on the tibial tuberosity. Males are more affected than females. It typically occurs in boys between 12-15 years and girls at 8-12 years.
Caused by repetitive tensile stress on insertion of patellar tendon over the tibial tuberosity, which results in minor avulsion at the site and a subsequent inflammatory reaction. (tibial tubercle apophysitis)
- tender lumb over tibial tuberosity
- pain on resisted leg extension
- anterior knee pain exacerbated by jumping or kneeling, but relived by rest.
- lateral knee: to visual fragmentation of the tibial tubercle with or without ossicles in the patellar tendon (very small bones, like the ones in the ear, see second image below)
Benign: self limiting but does not resolve until growth halts.
- Restrict intensive activities
- NSAIDs with rest and both flexibility and isometric strengthening exercises.
Isometric exercise or isometrics are a type of strength training in which the joint angle and muscle length do not change during contraction
- Casting if symptoms do not resolve with conservative management
- ossicle excision in refractory cases (done in patients with mature skeleton and persistent symptoms)